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    ASTHMA

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    Ayesigwa Gerald96
    Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

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    ASTHMA

    Uploaded by

    Ayesigwa Gerald96
    377 views16 pages
    Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

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    Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    377 views16 pages

    ASTHMA

    Uploaded by

    Ayesigwa Gerald96
    Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    ASTHMA IN CHILDREN

    presented by Mbekeka Angella

    presented by Mbekeka Angella


    Defnition
    Asthma is a chronic inflammatory disease of the
    airways. Symptoms range from mild to severe,
    intermittent to chronic.
    Untreated or under treated, asthma can lead to severe
    respiratory distress and in rare cases, sudden death.
    It can be classified into acute and chronic asthma.

    presented by Mbekeka Angella


    GENERAL SIGNS AND SYMPTOMS OF
    ASTHMA
    Wheezing
    Chronic or recurrent cough
    Tight feeling in the chest
    Shortness of breath
    Rapid breathing
    Nasal flaring
    Anxiety
    Feeling weak or tired

    presented by Mbekeka Angella


    Risk factors for developing asthma

    A family history of allergy, eczema and asthma


    Smoking in the home.
    House dust and dust mites.
    Premature Births < 36 weeks of gestation.
    Presence of Pets in families

    presented by Mbekeka Angella


    Triggers:
    Allergic- such as dust mites
    Non-allergic- such as exercise, viral infections, smoke or
    other irritants.
    These triggers cause inflammation and afterwards,
    tightening of the airway muscles.
    Only those with allergic asthma have symptoms triggered
    by allergens such as pet dander, pollen and dust mites.
    About 80- 90 % of adults with asthma have allergic
    triggers.

    presented by Mbekeka Angella


    Cont
    The body attempts to expel the allergen/s by releasing
    several chemicals including histamines, causing
    sneezing, runny noses, watery eyes and broncho-
    constriction.
    Histamines cause bronchial smooth muscles to
    contract which in turn, makes exhaling more difficult.
    In a child with asthma, histamine can also trigger
    asthma symptoms.

    presented by Mbekeka Angella


    Pathophysiology
    Incase of a trigger factor for example allergens the
    body tries to produce chemical histamine which brings
    about a running nose, watery eyes and Broncho
    constriction. These histamines in excess cause smooth
    muscles of the bronchus to constrict making exhaling
    very difficult bringing about a difficult in breathing,
    wheezing etc.
    There excess histamine release in the body tend to
    exacerbate asthma attacks.

    presented by Mbekeka Angella


    Acute severe asthma. (STATUS
    ASTHMATICUS)
    Clinical diagnosis is defined by increasingly severe
    asthma not responsive to drugs that are usually
    effective.

    presented by Mbekeka Angella


    Features of acute severe asthma
    Cyanosis or SaO2<92%.
    Severe chest retractions and use of accessory muscles.
    Inability to talk in an older child.
    Silent chest on auscultation (minimal air exchange).
    Pulsus paradoxicus >20mmHg (the difference in
    systolic arterial blood pressure in inspiration and
    expiration doesn’t normally exceed 10mmHg).
    Lethargy or changes in mental status.
    Hypercapnia (CO2 retention-PaCO2
    >50mmHg/>7kpa.

    presented by Mbekeka Angella


    Management
    Before specific therapy the patient must be given high
    flow oxygen.
    Subcutaneous adrenaline 0.01ml/kg/dose (max 0.3ml)
    can be repeated twice, 20min apart.
    Nebulised salbutamol or albuterol given every 3hrs.
    IV hydrocortisone 6mg/kg/dose 6hrly for 24hrs.

    presented by Mbekeka Angella


    Management -cont
    IV aminophyline 6mg/kg as a loading dose and then
    5mg/kg/dose every 6hrs or 1mg/kg/hr. watch out for
    signs of toxicity like tachycardia, vomiting,
    arrhythmias.
    Prednisolone orally 1-2mg/kg/day for 5 days.
    No sedation should be given even if the child is
    restless.

    presented by Mbekeka Angella


    Supportive therapy
    Give oxygen at a concentration of 100%. Remember
    all children with severe asthma are hypoxic. The SaO2
    should be >95%.
    Maintain hydration by IV fluids or NGT.
    Antipyretics should be given if the child is febrile.
    Antibiotic should be considered if particularly the
    child has a high temperature or localizing signs on
    CXR.

    presented by Mbekeka Angella


    Investigations
    FBC
    Oxygen saturation, capillary or arterial blood gases..
    Blood chemistry- Na, K, Cl, bicarbonate, and glucose.
    Chest X-Ray.

    presented by Mbekeka Angella


    Cautions
    If despite the above treatment the child’s condition
    does not improve or worsens, then refer immediately
    to the intensive care ward for intubation and artificial
    ventilation.
    Remember that all that wheezes is not only asthma.
    Consider other possibilities if it is the first episode and
    response is poor.

    presented by Mbekeka Angella


    Complications
    Pneumothorax .
    Lung collapse.
    Mediastinal empysema.

    presented by Mbekeka Angella


    Follow up
    Continue oral steroids at discharge for a total of 5
    days.
    Metered dose inhaler of β2 agonists for mild
    attacks.
    Home nebuliser for moderate asthma attacks.
    Inhaled steroids or sodium chromoglycate if the
    child has recurrent admissions for severe asthma.
    Counselling of the child about precipitating factors
    (e.g. pollution, smoking, dust), explain drug
    management and when they should bring their
    child to hospital (e.g. signs of severe distress: baby
    not breastfeeding, child unable to talk.)
    presented by Mbekeka Angella

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